“What happens is actually pretty simple,” Dr. Sydney Spiesel explained toNPR.

“The administerer of the hickey applies lips to the neck and creates a vacuum.

Can someone giving you a hickey ever cause serious harm?

Man kissing woman’s neck

Some bruises, of course, are worse than others.

While strokes induced by hickeys are extremely rare, they’re not a thing of fiction either.

How can you avoid endangering your partner’s health?

Woman hiding her throat

If the clots grow large enough, they can block blood flow to the brain, inducing a stroke.

All of that’s to say, location is key.